Diet, Exercise and Lifestyle
Anybody who has ever tried to lose weight, especially a significant amount of weight, knows that it is like trying to swim upstream against a strong current. If you just let go and do nothing, you drift away.
Diet, exercise and behavioural modifications alone produce modest results.
Weight loss studies have found that participants with obesity, who were managed with diet, exercise and lifestyle intervention mostly lost only 5-7% of initial body weight . Less than half lost more than 10%. Sustained weight loss of more than 5% of initial body weight is regarded as a good medical result.
However, most people regain part or all of weight lost within 18-24 months.
The paradox of exercise and diet is that whilst they do not stand out as being effective in inducing initial weight loss, they consistently stand out as important factors in maintaining weight loss after initial weight reduction.
All weight loss drugs developed to date achieve modest results.
Weight loss of 10% (of initial weight) is considered a very good response. Many drugs have been withdrawn or ill-tolerated because of their side effects.
Sibutramine (brand name Reductil) for instance, was withdrawn in Australia by the pharmaceutical company Abbott in 2010.
The FDA recently approved a new drug called Belviq. Using this drug, patients lose 3-3.7 per cent if their initial weight over the first year. It obtained FDA approval because 47% of patients lost at least 5 per cent of their starting weight, which is enough to meet FDA standards for effectiveness. It was the firtst new drug to be approved in 13 years.
Drug therapy does not cure obesity. When drug therapy is stopped, the weight is regained.
It has been suggested that combining two drugs could be more effective than single drug therapy. However, there is no long term data supporting this and combination drugs are poorly tolerated. Less than half of study participants were able to complete a year of therapy due to side effects.
Weight loss supplements such as guar gum, green tea, chromium, chitosan, ginseng, hoodia gordonii etc. are widely available. However, with the exception of chitosan and guar gum, their efficacy and safety have not been established in clinical trials. Chitosan and guar gum have been shown to be ineffective for weight loss and caused adverse effects. Their use is discouraged.
In many cases, patients have tried numerous weight loss drugs, appetite suppressants, thermogenic fat burners, weight loss tablets, sprays and diet programs – all to no avail. They often end up following a pattern of yo-yo dieting, feeling that permanent weight loss is unsustainable.
The good news is, there are solutions to help re-shape your future.
Currently, surgery is the only way to achieve significant weight loss.
At the Surgical Weight Loss Centre we will meet with you, carefully go through your medical history and explain your customised treatment options.
We believe that every patient should be given the opportunity to shape his or her future. We will ensure that you understand everything clearly. Knowledge is power.
Some of the benefits of weight loss surgery compared to other methods of weight loss include:
The surgery immediately induces satiety.
As the weight loss is faster than other methods it has a major impact on life expectancy and quality of life and is the most effective way to resolve common and serious diseases that are associated with morbid obesity.
Weight loss surgery patients can achieve a loss of more than 50% of their excess body weight over time, dependant on the individual’s general health and dietary plan commitment.
When you make the informed decision to embark on weight loss surgery you will be closely supported by our expert Surgical Weight Loss Centre team, not just around the time of your surgery, but for the crucial and exciting months and years that follow.
What Is BMI ?
The Body Mass Index (BMI) is a practical way to evaluate the degree of being overweight (see the BMI calculator in the left side bar). It indicates whether your weight is appropriate for your height. Another important measurement is the hip to waist circumference ratio.
- If your BMI is between 25 and 29.9, you are overweight.
- If your BMI is 30 or greater, you are obese.
- The higher the BMI, the higher the risks associated with obesity.
- A BMI of 30-34.9 is classified as moderate obesity.
- A BMI of 35-40, severe obesity.
- Anybody with a BMI greater than 40 has very severe obesity.
- The “normal” range for BMI is between 18.50 and 24.99.
- If your BMI is under 18.50 you are considered underweight.
BMI can be inaccurate, because weight refers to your total body weight, it does not discriminate between the weight of your body fluid, fat, muscle and bone. See the graphic below & story on our blog.
For example, some body builders with very high muscle mass can have a BMI in the obesity range because of their heavy muscles, but have a very low fat mass and are therefore not obese at all.
You can also have a higher BMI if you have a lot of fluid/swelling on board. A female can gain 2kg of body weight before menstruation because of fluid retention.
The “normal” range for asians (as opposed to caucasians) lies between 18.5 and 23.
Another important way (maybe even more accurate than BMI) to measure overweight/obesity is the waist to hip circumference ratio.
Abdominal fat correlates with the risk of heart disease and metabolic complications. A bigger waist circumference indicates a higher cardiovascular risk. An apple shaped person would have a higher risk of heart disease and other complications than a pear shaped person with the same weight or BMI.
To measure your waist, exhale and relax. Measure the narrowest point. At the sides this point would be halfway between the lowest ribs and the upper part of your hip bone. The tape should pass above your umbilicus in front, not at the belt line.
Hips are measured at the widest point.
The RATIO is the waist circumference (cm) divided by the hip circumference (cm)
Healthy target values are less than 0.95 for men and less than 0.85 for women.
The following table provides a summary: